CAMERON REGIONAL MEDICAL CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CAMERON REGIONAL MEDICAL CENTER INC (EIN 44-0668347)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-15
- IRS object ID
- 201302279349300605
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T07:01:02-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481026809 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440668347 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAME | NameControl |
| Phone | 8166322101 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joseph Abrutz Jr | Name |
| Title | Administrator | Title |
| Phone | 8166322101 | Phone |
| Date Signed | 2013-08-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Derek H Hart | Name |
| PTIN | P01054116 | PTIN |
| Phone | 7852334226 | Phone |
| Date Prepared | 2013-08-02 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Joseph Abrutz Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 55307376 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1963 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | To provide acute inpatient and outpatient medical care to area residents regardless of ability to pay. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 495 | TotalNbrEmployees |
| Total Nbr Volunteers | 120 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 8004 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 51623 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 51136034 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 54000316 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 976338 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1051924 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 188493 | OtherRevenuePriorYear |
| Other Revenue Current Year | 159718 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 52308869 | TotalRevenuePriorYear |
| Total Revenue Current Year | 55263581 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22743648 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 23775178 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1645 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 25397049 | OtherExpensePriorYear |
| Other Expenses Current Year | 28132839 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 48140697 | TotalExpensesPriorYear |
| Total Expenses Current Year | 51908017 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4168172 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3355564 | RevenuesLessExpensesCY |
| Total Assets BOY | 58637423 | TotalAssetsBOY |
| Total Assets EOY | 66680403 | TotalAssetsEOY |
| Total Liabilities BOY | 23152981 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 25585331 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 35484442 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 41095072 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Our mission at Cameron Regional Medical Center, Inc., is caring for all patients. To this end, we organize people, equipment, and facilities in a manner that best responds to their needs and to the needs of our service area. Our priorities are: patients and families; physicians; and employees. Our goal is to be a regionally-recognized leader in patient satisfaction by exceeding customer expectations and continuing to achieve excellence in quality and cost-effective health care services. CRMC will provide services in an atmosphere that involves compliance with governmental mandates. Throughout our organization, our employees strive to provide sensitive, quality health care at all times by living our values. Lastly, CRMC recognizes the importance of viable and profitable operations to guarantee the continued existence/growth of the facility. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 46850679 | Expense |
| Revenue | 54305589 | Revenue |
| Description | Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay. | Description |
| Total Program Service Expense | 46850679 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 495 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MO | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joseph Abrutz Jr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8166322101 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen St | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Warren McElwain | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Steve Huitt | |||||||
| Vice-President | 1.00 | X | X | 0 | 0 | 0 | |
| Jennifer White | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Michael Poland | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Weldon Wilhoit | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Barbara Ballew | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Ken Raffety | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Steve Tinnen | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Mike Brown | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| David Just | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Kendall DeSelms DO | |||||||
| Physician & Director | 41.00 | X | 254092 | 0 | 0 | ||
| Muhammad Amin DO | |||||||
| Physician & Director | 40.00 | X | 278096 | 0 | 0 | ||
| Joseph F Abrutz Jr | |||||||
| Administrator | 40.00 | X | 388953 | 0 | 9210 | ||
| Rosa Patti | |||||||
| Chief Financial Officer | 41.50 | X | 94088 | 0 | 14000 | ||
| John Barton III | |||||||
| Physician | 40.00 | 353773 | 0 | 0 | X | ||
| John Schiro | |||||||
| Physician | 40.00 | 244888 | 0 | 0 | X | ||
| William Spalding | |||||||
| CRNA | 40.00 | 269108 | 0 | 0 | X | ||
| Shahzad Shafique | |||||||
| Physician | 40.00 | 288466 | 0 | 0 | X | ||
| Laeeq Azmat | |||||||
| Physician | 40.00 | 591431 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2762895 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 23210 | TotalOtherCompensation |
| Number Individuals GT100 K | 19 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Cameron Emergency Physicians PC | |||||
| 1600 E Evergreen | Cameron | MO | 64429 | Emergency physicians | 1176986 |
| Premier Specialty Network | |||||
| 1835 E Republic Rd Suite 200 | Springfield | MO | 65804 | Physician specialists | 849851 |
| Wendling Noe Nelson & Johnson | |||||
| 534 S Kansas Ave Suite 1500 | Topeka | KS | 66603 | Auditing/Accounting | 194844 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | Dallas | TX | 75397 | Surgeon | 149271 |
| Barton & Associates | |||||
| 10 Dearborn Rd | Peabody | MA | 01960 | Emergency physicians | 140420 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 51623 | AllOtherContributions |
| Total Contributions | 51623 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient service revenu | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 54000316 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54000316 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 54000316 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 724575 | TotalRevenueColumn |
| Exclusion | $724,575 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22076 | TotalRevenueColumn |
| Exclusion | $22,076 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 52565 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 52565 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52565 | TotalRevenueColumn |
| Exclusion | $52,565 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 307929 | Securities |
| Other | 833 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 3489 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 307929 | Securities |
| Other | -2656 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 305273 | TotalRevenueColumn |
| Related Or Exempt Function Income | 305273 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 66477 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 40306 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26171 | TotalRevenueColumn |
| Exclusion | $26,171 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria | 722210 | 77542 | $77,542 |
| Other income | 900099 | 3440 | $3,440 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 80982 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55263581 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54305589 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $906,369 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1017010 | Total |
| Program Services | 541758 | ProgramServices |
| Management And General | 475252 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18940244 | Total |
| Program Services | 17590968 | ProgramServices |
| Management And General | 1349276 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 294694 | Total |
| Program Services | 272898 | ProgramServices |
| Management And General | 21796 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2145446 | Total |
| Program Services | 1968382 | ProgramServices |
| Management And General | 177064 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1377784 | Total |
| Program Services | 1253315 | ProgramServices |
| Management And General | 124469 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169964 | Total |
| Management And General | 169964 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149357 | Total |
| Management And General | 149357 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 344297 | Total |
| Program Services | 128320 | ProgramServices |
| Management And General | 215977 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1025659 | Total |
| Program Services | 717033 | ProgramServices |
| Management And General | 308626 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 510641 | Total |
| Program Services | 442165 | ProgramServices |
| Management And General | 68476 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 320174 | Total |
| Program Services | 266429 | ProgramServices |
| Management And General | 53745 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 970952 | Total |
| Program Services | 970952 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2771429 | Total |
| Program Services | 2397009 | ProgramServices |
| Management And General | 374420 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 267418 | Total |
| Program Services | 39635 | ProgramServices |
| Management And General | 227783 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 7448059 | 7448059 | |
| Medical professional fe | 3276712 | 3187813 | 88899 |
| Medical supplies | 3192948 | 3192948 | |
| Pharmaceuticals | 2714979 | 2714979 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4970250 | Total |
| Program Services | 3718016 | ProgramServices |
| Management And General | 1250589 | ManagementAndGeneral |
| Fundraising | 1645 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51908017 | Total |
| Program Services | 46850679 | ProgramServices |
| Management And General | 5055693 | ManagementAndGeneral |
| Fundraising | 1645 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23604 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7154136 | BOY |
| EOY | 6474364 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10848960 | BOY |
| EOY | 13087101 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 780492 | BOY |
| EOY | 657159 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 288529 | BOY |
| EOY | 291482 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 47021079 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26628128 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17996208 | BOY |
| EOY | 20392951 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18141018 | BOY |
| EOY | 21890670 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3404476 | BOY |
| EOY | 3886676 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58637423 | BOY |
| EOY | 66680403 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3518980 | BOY |
| EOY | 4364436 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18670542 | BOY |
| EOY | 20534810 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 963459 | BOY |
| EOY | 686085 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23152981 | BOY |
| EOY | 25585331 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34881578 | BOY |
| EOY | 40487386 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 602864 | BOY |
| EOY | 607686 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35484442 | BOY |
| EOY | 41095072 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58637423 | BOY |
| EOY | 66680403 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3355564 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2255066 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16182264 | OtherCostOrOtherBasis |
| Depreciation | 7976119 | Depreciation |
| Book Value | 8206145 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25370392 | OtherCostOrOtherBasis |
| Depreciation | 18473703 | Depreciation |
| Book Value | 6896689 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5468423 | OtherCostOrOtherBasis |
| Depreciation | 178306 | Depreciation |
| Book Value | 5290117 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20392951 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deferred debt issuance costs | 468995 |
| Third party payor settlements | 2563301 |
| Beneficial interest in net assets of CRMC Foundation | 428805 |
| Other receivables | 380928 |
| Accrued interest and dividends | 44647 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3886676 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital lease obligations | $574,084 |
| Third party payor settlements | $112,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 686085 | TotalOfAmounts |
| Total Revenue | 55263581 | TotalRevenue |
| Total Expenses | 51908017 | TotalExpenses |
| Excess Or Deficit For Year | 3355564 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2190869 | NetUnrealizedGLOnInvestments |
| Other | $64,197 | OtherAmount |
| Total Adjustments | 2255066 | TotalAdjustments |
| Excess Or Deficit Per FS | 5610630 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 47855828 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 40306 | OtherRevenues |
| Revenue Not Rptd F990 | 40306 | RevenueNotRptdF990 |
| Revenue Subtotal | 47815522 | RevenueSubtotal |
| Other Revenues Not Included | 7448059 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 7448059 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 55263581 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 44500264 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 40306 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 40306 | ExpensesNotRptdF990 |
| Expenses Subtotal | 44459958 | ExpensesSubtotal |
| Other Expenses Not Included | 7448059 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 7448059 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 51908017 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on its related income pursuant to Section 501(a) of the Code. Management is not aware of any uncertainties in income tax positions. The years ended September 30, 2012, 2011, 2010, and 2009, remain subject to examination for both federal and state purposes. |
| Part XI, Line 8 - Other Adjustments: | Change in beneficial interest in net assets of CRMC Foundation 88,433. Other decreases in temporarily restricted net assets -24,236. Total to Schedule D, Part XI, Line 8: 64,197. | |
| Part XII, Line 2d - Other Adjustments: | Fundraising event direct expenses 40,306. | |
| Part XII, Line 4b - Other Adjustments: | Provision for bad debts 7,448,059. | |
| Part XIII, Line 2d - Other Adjustments: | Fundraising event direct expenses 40,306. | |
| Part XIII, Line 4b - Other Adjustments: | Provision for bad debts 7,448,059. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Tournament | NameOfEvent1 |
| Gross Receipts Event1 | 66477 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 66477 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 5815 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 15935 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 12471 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3174 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 2911 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 66477 | GrossReceiptsTotal |
| Gross Revenue Total Events | 66477 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 5815 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 15935 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 12471 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3174 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 2911 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 40306 | DirectExpenseSummaryEvents |
| Net Income Summary | 26171 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 127.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 841497 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 780374 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 61123 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6775762 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5490076 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1285686 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02890 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7617259 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6270450 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1346809 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03030 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 199153 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3508 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 195645 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38564 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11125 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 27439 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7371910 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4672717 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2699193 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18132 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18132 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7627759 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4687350 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2940409 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06610 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15245018 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10957800 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4287218 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09640 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,997,002 | BadDebtExpenseAmount |
| Amount Attributable To | 299700 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 16295960 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17806663 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1510703 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 127.000000000000 | FPGDiscountPercent |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 13 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (13 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Cameron Medical Clinic | ||||
| 1600 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Walnut Medical Clinic | ||||
| 221 E 7th Street | Cameron | MO | 64429 | Medical Clinic |
| Westside Medical Offices | ||||
| 1608 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Cameron Specialists - Internal Medicine | ||||
| 1608 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Hamilton Family Health Center | ||||
| 212 N Davis | Hamilton | MO | 64644 | Rural Health Clinic |
| Plattsburg Family Medicine | ||||
| 214 N Main | Plattsburg | MO | 64477 | Rural Health Clinic |
| Jamesport Outreach Clinic | ||||
| 409 W Auberry Grove | Jamesport | MO | 64648 | Rural Health Clinic |
| Stewartsville Medical Clinic | ||||
| 106 E 4th | Stewartsville | MO | 64490 | Rural Health Clinic |
| Pattonsburg Medical Clinic | ||||
| 110 N Central Ave | Pattonsburg | MO | 64670 | Rural Health Clinic |
| Polo Family Health Center | ||||
| 101 E Meadowbrook | Polo | MO | 64671 | Rural Health Clinic |
| Gallatin Family Medicine | ||||
| 502 S Main | Gallatin | MO | 64640 | Rural Health Clinic |
| Lathrop Medical Clinic | ||||
| 705 Oak Street | Lathrop | MO | 64465 | Medical Clinic |
| Bethany Medical Clinic | ||||
| 3202 Millter St | Bethany | MO | 64424 | Medical Clinic |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation |
|---|
| Part I, Line 7: A cost-to-charge ratio derived from Worksheet 2 was used to clculate the amounts reported on line 7. |
| Part I, Line 7g: The costs of subsidized health services include costs attributable to multiple physician clinics in the amount of $5,019,506. |
| Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 7448059. |
| Part III, Line 4: This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year.The amount on line 3 was determined based on the overall income level of patients that submit all required documentation under the Medical Center's financial assistance policy.Financial statement footnote: On the basis of historical experience, a significant portion of the Medical Center's uninsured patients will be unable or unwilling to pay for the services rendered. Thus, the Medical Center records a significant provision for bad debts related to uninsured patients in the period the services are provided. |
| Part III, Line 8: Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year.The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area. |
| Part VI, Line 2: The Medical Center relies on the feedback and requests taken from patients of the Medical Center and its numerous clinics, as well as the residents from the primary service area. |
| Part VI, Line 3: The Medical Center employs a social worker that informs all patients of all available payment options. Each patient receives a HELP program brochure to ensure that the patient has all information needed. |
| Part VI, Line 4: Cameron Regional Medical Center and its seven rural health clinics are located in Northwest Missouri. The primary service area is comprised of four rural counties consisting of Daviess, Caldwell, DeKalb, and Clinton. There are approximately 51,492 individuals that reside in the primary service area. Of these residents approximately 11.1% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately $44,587. Approximately 47% of the total services provided are for Medicare patients and 15% are for Medicaid patients. The nearest surrounding hospitals are located in Smithville, Excelsior Springs, and Richmond. The distance between these facilities and Cameron Regional Medical Center is approximately 28, 28, and 31 miles respectively. |
| Part VI, Line 5: Cameron Regional Medical Center's governing body is comprised of residents from the primary service area. The Medical Center extends medical privileges to all local physicians who meet the requirements of the medical staff bylaws. All surplus funds are used to maintain and improve the medical facility and medical equipment in order to provide the best medical treatment possible to every patient. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kendall DeSelms DO | |||||||||||||
| 254092 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 254092 | 0 | 0 | 0 |
| Muhammad Amin DO | |||||||||||||
| 278096 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 278096 | 0 | 0 | 0 |
| Joseph F Abrutz Jr | |||||||||||||
| 262467 | 0 | 126486 | 0 | 0 | 0 | 0 | 0 | 9210 | 0 | 398163 | 0 | 0 | 0 |
| John Barton III | |||||||||||||
| 353773 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 353773 | 0 | 0 | 0 |
| John Schiro | |||||||||||||
| 244888 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 244888 | 0 | 0 | 0 |
| William Spalding | |||||||||||||
| 260608 | 0 | 8500 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 269108 | 0 | 0 | 0 |
| Shahzad Shafique | |||||||||||||
| 288466 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 288466 | 0 | 0 | 0 |
| Laeeq Azmat | |||||||||||||
| 591431 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 591431 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| The Industrial Development Authority of the City of Cameron Missouri | |||||||
| 431679396 | 133451BF0 | 2007-05-17 | 10000000 | Refund Series 2000 bonds issued on 12/13/2000 | 0 | 0 | 0 |
| The Industrial Development Authority of Clinton County Missouri | |||||||
| 521734480 | 133451AB6 | 2007-05-17 | 9994879 | Refund Series 2000 bonds issued on 12/13/2000 and purchase equipment | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|
| 1685000 | 10000000 | 197701 | 4037 | 9798262 | 2007 | 0 | 1 | 1 | 1 |
| 9994879 | 197054 | 913437 | 8884388 | 2007 | 0 | 1 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | A copy of form 990 is made available to the governing body prior to filing. | |
| Form 990, Part VI, Section B, line 12c | Employees and Directors are required to complete an annual disclosure information form. | |
| Form 990, Part VI, Section C, line 19 | Organization makes its governing documents available upon request. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 2,190,869. Change in beneficial interest in net assets of CRMC Foundation 88,433. Other decreases in temporarily restricted net assets -24,236. Total to Form 990, Part XI, Line 5: 2,255,066. | Changes in Net Assets or Fund Balances: |
| 990, Part XI, Page 11, Line 2c | Cameron Regional Medical Center's Finance Committee is responsible for each of these functions. | Financial Statements and Reporting |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742933060 | EIN |
| Primary Activities | To support the operation of the Cameron Regional Medical Center, Inc.. | PrimaryActivities |
| Legal Domicile State | MO | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 170(b)(1) (A)(vi) | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |